Health and care services for an ageing population

22.12.12

4 Deputy G.P. Southern of St. Helier Central of the Minister for Health and Social Services regarding health and care services for an ageing population (OQ.132/2022)

Will the Minister undertake to provide Members with the questions to be asked as part of the consultation process about how the public would propose to pay for health and care services for an ageing, but healthy, population; and will she outline what measures she proposes to use to ensure that any solutions proposed by the public are based on an informed understanding and not random suggestions with unforeseen consequences?

Deputy K. Wilson of St. Clement (The Minister for Health and Social Services):

As Members will be aware, a survey that seeks to understand more of our Islanders’ attitudes to healthcare funding will be distributed to 3,500 randomly selected households. The survey was to be distributed in October/November but I made the decision to delay until early next year on the basis of feedback provided by members of the public who participated in 2 independently-facilitated focus group sessions. They and the chief statistician suggested that we should avoid the pre-Christmas period. I am happy to provide the questions to Members of course and will do so before the survey is distributed. The survey is not proposing solutions to the public. It is asking questions about their attitudes to healthcare funding. The answers provided by the public will help us, as Government, to develop potential funding solutions for more in-depth consultation later in 2023.

1. Deputy G.P. Southern :

The question remains: how is she going to assure herself and us that the questions to be asked are relevant and go to the issues about health and care treatment on the Island?

Deputy K. Wilson :

The questions, many of which are included, are based on standard questions that are used by U.K. (United Kingdom) institutions to understand attitudes to healthcare funding. They have been reviewed by the chief statistician to ensure that they are open, understandable and non-biased. We have also welcomed the involvement of G.P.s (general practitioners) in that consultation on how the questions should be phrased. I think we also want to assure the Assembly that we have also contracted specialist health economists to support our work to develop these healthcare funding solutions. In addition to providing detailed financial models to help us better understand future expenditure and revenue requirements they are also undertaking extensive research of the funding model used in other jurisdictions to support us to make these informed decisions about how we go forward.

2. Deputy R.J. Ward :

May I ask the Minister in regards the random process of allocation and what process of random will be used? May I suggest whether the Minister would use the process of sortition, as it was stratified sampling, because when it takes a survey like this, it is really important we get a good view. I wonder if the Minister has considered taking that approach rather than just genuinely random, which may not be on a small population.

Deputy K. Wilson :

What I would like to do is, because I do not have the details of the sampling methodology today, I would be happy to share those with him.

 

3. Deputy S.Y. Mézec :

The Minister referred to survey questions seeking to find out the attitude of people towards how to pay for health and care services. Does the Minister understand that somebody’s attitude for how much they are prepared to pay will be largely dependent on how much disposable income they have to enable them to be able to pay? Would she ensure that however these responses are collated at the end, that they are presented in such a context that understands that people’s levels of disposable income will have a direct impact on their attitude towards how much they pay and may not be considerate of how we, as a society, pay, bearing in mind lots of people cannot afford to pay more?

Deputy K. Wilson :

Yes, clearly those issues will be taken into account. The questions have also been informed by the feedback that we have received from the participants in the focus groups. I think when we have more clarity about the way in which the consultation process will unfold I will be able to address some of those issues for him.

4. Deputy S.Y. Mézec :

I am aware of a previous survey that I believe was conducted by someone else, not her department, which reached a headline conclusion that the public were happy to pay for primary care because that is what the majority of responses they got said. But when you scratch beneath the surface you saw a direct link between those with more disposable income being happy and those without disposable income not be able ... whether they are happy or not, not be able to pay for those services. Will she confirm that in conducting this exercise they have learnt lessons from previous ones and will not repeat the mistake that has been done previously?

Deputy K. Wilson :

If I could just assure the Deputy that in circulating the questions before they are actually distributed it may well provide an opportunity to address those particular concerns that he has.

5. Deputy G.P. Southern :

Does the Minister agree with me that we must not lose sight in this process of services being free at the point of delivery, as they are in many places on the Island currently?

Deputy K. Wilson :

I think all of the issues that participants of people who have been involved in this conversation previously, as well as now, will be taken into account as part of the way in which we will develop our consultation going forward in 2023. It is clear that there are different opportunities, there are different options, there are different perspectives about the future healthcare funding model that we should develop going forward. As Members will know, there is already work underway to address the sustainable health funding model for the future. The issues which the Deputy has raised will be considered as part of that.